BCPS Oncology & Hematology Pharmacotherapy 2

Question 1

Which of the following adverse effects requires close monitoring in patients receiving imatinib for chronic myeloid leukemia?

Accepted Answer

Fluid retention and peripheral edema

Answer

Pulmonary fibrosis

Answer

Severe hyperkalemia

Answer

Major QTc prolongation

Question 2

5-Fluorouracil (5-FU) exerts its primary antineoplastic effect by inhibiting which enzyme?

Accepted Answer

Thymidylate synthase

Answer

Dihydrofolate reductase

Answer

Topoisomerase I

Answer

Ribonucleotide reductase

Question 3

Which intervention is MOST important to prevent cisplatin-induced nephrotoxicity?

Accepted Answer

Aggressive IV saline hydration before and after cisplatin infusion

Answer

Administering amifostine as a cytoprotectant

Answer

Prophylactic N-acetylcysteine orally

Answer

Urinary alkalinization with sodium bicarbonate

Question 4

A patient with active cancer develops a proximal deep vein thrombosis (DVT). According to current ASCO guidelines, which is the preferred anticoagulation strategy?

Accepted Answer

Low molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC)

Answer

Warfarin with a target INR of 2-3

Answer

Unfractionated heparin bridge followed by warfarin

Answer

Aspirin 325 mg daily

Question 5

Which of the following is an appropriate indication for erythropoiesis-stimulating agents (ESAs) in a patient with cancer?

Accepted Answer

Anemia (Hgb ≤10 g/dL) in a patient receiving palliative chemotherapy

Answer

Anemia (Hgb ≤10 g/dL) in a patient receiving curative-intent chemotherapy

Answer

Iron deficiency anemia regardless of chemotherapy status

Answer

Pre-operative anemia before elective cancer surgery

Question 6

Pegfilgrastim (a granulocyte colony-stimulating factor) is recommended as primary prophylaxis when the risk of febrile neutropenia from a chemotherapy regimen is at least:

Accepted Answer

20%

Answer

5%

Answer

10%

Answer

35%

Question 7

Tamoxifen is used in hormone receptor-positive breast cancer. Its primary mechanism of action is:

Accepted Answer

Selective estrogen receptor modulation, acting as an antagonist in breast tissue

Answer

Aromatase inhibition, reducing peripheral estrogen synthesis

Answer

Progesterone receptor agonism that down-regulates estrogen receptors

Answer

HER2/neu receptor blockade via monoclonal antibody binding